Issue

Recent studies have suggested that certain psychiatric disorders occur with increased frequency among older adults with type 2 diabetes mellitus for several reasons.1,2 First, diabetes is considered to be one of the most psychologically and behaviorally demanding of the chronic medical illnesses. Multiple coping strategies are necessary to deal with the losses that can occur with aging. Because 95% of the management of diabetes is conducted by the patient, a diagnosis of diabetes can lead to increased levels of anxiety, depressive symptoms, and lowered self-esteem. This is often true in indivi

CASE PRESENTATION
A 74-year-old widowed white male is brought to the emergency room due to severe weakness, nausea, and vomiting. Mr. R lived in a subsidized apartment building for older adults. The supervisor called an ambulance after other tenants were concerned because Mr. R had not come to meals in the dining room for 3 days. He was found lying in bed, unable to get up. In the emergency room, Mr. R was noted to have generalized weakness, bilateral fine hand tremors, and a palpable, enlarged thyroid gland. His skin was pale and dry, and he displayed edema in his arms and legs. He appeared

CASE PRESENTATION
A 69-year-old male is seen for an annual examination. He reports to his physician that he has a decrease in his libido, a decrease in the rigidity of the penis during sexual intimacy as well as rapid detumescence, a loss of energy, and is falling asleep after meals. The physical exam reveals a 3/4” loss of height since that recorded at his last examination, and decreased hair on his arms and legs. He has a minimally enlarged benign prostate gland. The serum testosterone was 220 ng/dL. The luteinizing hormone (LH) and prolactin levels were normal. Prostate-specific antigen

This is the first article of a two-part series dealing with the effects of terrorism on the elderly. Part I addresses specific data as it relates to the medical impact of biological, chemical, nuclear, and bombing attacks on senior citizens. Part II will review the literature as it relates to the occurrence of psychiatric disorders in the elderly following terrorist attacks. The authors will attempt to identify and review data specific to senior citizens, and to provide the clinician with useful information regarding differential diagnosis, the nature of symptoms likely to be encountered, time

 
ACCREDITATION
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.
CREDIT DESIGNATION STATEMENT
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participa

August 2006

This continuing medical education activity is presented by the Johns Hopkins University School of Medicine, Baltimore, Maryland. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

These examination questions are based on the article “Use of Travel Vaccines in Older Adults,” which appears on pages 36-44 in this issue of Clinical Geriatrics.

ACCREDITATION
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education

Vaccine to Cut Risk of Shingles in Older People Is Approved” read the headline in the Health section of The New York Times. To the casual reader this may pale in comparison to the bombings in Iraq, the baseball scores, or the weather forecast for the weekend. To me, it spoke of hope.

Today’s generation of elderly individuals unfortunately did not have the ability to take advantage of modern medicine’s knowledge of preventive healthcare measures and the myriad of new technology that has changed the face of medicine today. Many of the diseases that are all too common in old age may hav

As physicians, we have been taught that our job is to make the correct diagnosis and then write the right prescription, assuming that our prescription would be filled. Enter Medicare Part D with its aim to increase access to medications for seniors. But has this actually occurred? A recently completed survey showed that 94% of physicians are confused about Medicare Part D, especially with regard to accessing specific prescriptions.1 This difficulty has resulted in 70% of physicians spending at least 20% more time on administrative tasks related to Medicare Part D.1 Clearly, Medicare Part D has